Last public hearing held on Pennsylvania Gov. Tom Corbett's Medicaid reform plan

Audience members at hearing are lukewarm to plan, which would establish possibly illegal work requirements on some Medicaid recipients.

January 09, 2014|By Steve Esack, Call Harrisburg Bureau

HARRISBURG — For the seventh and final time, Bev Mackereth took to a stage to tell a largely skeptical audience why her boss' plan to reform and expand Medicaid to more poor Pennsylvanians was a better option than the one available to states under the federal Affordable Care Act.

Mackereth, secretary of the state Department of Public Welfare, told a crowd at the State Museum of Pennsylvania here that Gov. Tom Corbett's Healthy Pennsylvania plan is not a cure-all for the estimated 500,000 uninsured residents. But the plan offers the best hope for creating a sustainable Medicaid program for future generations, she said.

"Truthfully, I think we have a very good Medicaid program in Pennsylvania," Mackereth said Thursday. "But that does not make it financially stable."

Corbett's plan is not a traditional entitlement program, she said. It requires some poor adults to perform work-search requirements and pay up to $25 in monthly premiums when using government subsidies to buy private insurance that meets the act's mandatory minimum coverage options.

The administration was required to hold the public hearings under the federal law because the state is seeking a waiver to set up its own version of Medicaid expansion for poor single adults earning between $5,745 and $11,490.

It could take months for the welfare department to sift through the public comments before submitting its official waiver request to the U.S. Department of Health & Human Services.

The audience members, many representing various medical, health and human services groups, lauded Corbett for proposing a Medicaid-expansion plan. They also criticized the plan for creating burdensome requirements for citizens or health-care providers.

State Rep. Gene DiGirolamo, R-Bucks, said the governor could help more people by expanding traditional Medicaid. When the administration complains about the cost of 2.2 million people on Medicaid, he said, it fails to explain that roughly half of them are children, more than 366,000 are elderly, more than 500,000 are disabled and roughly 86,000 are chronically ill adults.

"While the Healthy PA plan continues to be negotiated with HHS, reports show that it could take as long as a year to a year and a half for the federal government to tell us what it will accept or not," DiGirolamo said.

The federal government has rejected other states' requests to institute work requirements for Medicaid recipients.

The Corbett administration does not appear willing to alter its stance on requiring some Medicaid recipients to work at least 20 hours a week or show proof they are looking through work by logging on to a state website multiple times a year.

Work requirements do not apply to pregnant women, children, the disabled, the elderly or institutionalized individuals.

Requiring Medicaid recipients to send 72 job applications in six months appears onerous and unrealistic, said Richard S. Edley, president and CEO of Rehabilitation & Community Providers Association, a Harrisburg umbrella roup of mental health and addiction counselors.

Mackereth's department has heard mixed reviews about the work requirement, she told the audience. But she said if children can get up and head to class each morning, adults should be able to go to work each morning, too.

The department is listening to public's concerns even if it cannot address all of them.

After hearing from hospital officials, she said, it is trying to determine a better way to collect a $10 co-payment for non-emergency care without forcing hospitals to do it, she said. In addition, Mackereth said, it may drop opposition to allowing the state's 200 federally sanctioned health centers to sell private Medicaid-like insurance on a private marketplace.